Green PANCE-Arrhythmias Flashcards
The clinical significance of an arrhythmia depends on….
- how much it impairs cardiac output
2. how likely it is to worsen into a more severe condition
Electrolyte abnormalities, hormonal imbalances, hypoxia, drug effects, and MI ischemia increase…
Susceptibility of arrhythmia
Presentation can range from asymptomatic to hemodynamic instability, shock and death
Arrhythmia
ECG monitoring, measurements of HR variability, signal averaged ECG, electrophysiologic testing and autonomic testing
Diagnostics for arrhythmias
HR under 60bpm
sinus bradycardia
When bradycardia causes symptoms, the rate is usually less than…
50 bpm
Sinus bradycardia (HR
Well conditioned athletes
If a pt is not a well conditioned athlete, sinus bradycardia (HR
Sinus node pathology, with increased risk of ectopic rhythms
HR >100 bpm
sinus tachycardia
…this occurs with fever, exercise, pain, emotion, shock, thyrotoxicosis, anemia, heart failure and use of many drugs
Sinus tachycardia (HR>100 bpm)
Tachycardia normally does not cause clinically signifiant symptoms until the rate is…
> 150 bpm
Atrial premature beats are usually a…
benign finding (requiring no treatment in the absence of symptoms)
What do patients with Paroxysmal supra ventricular tachycardia typically complain of?
“Racing heart”
Paroxysmal supraventricular tachycardia usually occurs in persons without…
structural
What is the most common chronic arrhythmia
Atrial fibrillation
Incidence and prevalence of A fib increase with…
Age
This arrhythmia can lead to a significant decrease in cardiac output and is the most common cause of embolic cerebrovascular accidents
A fib
This is called “holiday heart” when caused by excessive alcohol use or withdrawel
A fib
This usually occurs in patients with COPD, heart failure, atrial septal defect or coronary artery disease
Atrial flutter
________ rhythms occur in patients with normal hearts or those with myocarditis, CAD or digitalis toxicity
Junctional
Patients may present with palpitations, angina, fatigue or other symptoms of heart failure
Arrhythmias
Unstable arrhythmias are treated with..
Electricity
Signs and symptoms of a(n) ________ arrhythmia include: chest pain, dyspnea, altered mental status and hypotension
Unstable
Patients with unstable BRADYcardia leading to hypotension, shock, altered mental status angina, or heart failure should be treated with either:
A vagolytic (ie atropine) OR Positive chronocotropic (ie epinephrine or dopamine)
Patients with unstable TACHYcardia leading to hypotension, shock, altered mental status, angina or heart failure should be treated with..
Synchronized cardioversion
anti-arrhythmic therapy may also be indicated, i.e. Beta blocker, lidocaine
A regular, narrow complex tachycardia usually represents…
AV nodal reentry tachycardia (ie PSVT)
